Provider Demographics
NPI:1689047193
Name:SALTZMAN UROLOGICAL ASSOCIATES
Entity Type:Organization
Organization Name:SALTZMAN UROLOGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NED
Authorized Official - Middle Name:
Authorized Official - Last Name:SALTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-332-0116
Mailing Address - Street 1:2000 WASHINGTON ST
Mailing Address - Street 2:660 GREEN
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1650
Mailing Address - Country:US
Mailing Address - Phone:617-332-0116
Mailing Address - Fax:617-332-4275
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:660 GREEN
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1650
Practice Address - Country:US
Practice Address - Phone:617-332-0116
Practice Address - Fax:617-332-4275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA58251207ZP0101X
MAMA54310208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM15291Medicare UPIN